Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.232
Filtrar
1.
BMC Psychiatry ; 24(1): 362, 2024 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-38745267

RESUMEN

BACKGROUND: Obsessive-compulsive disorder (OCD) is characterized by persistent, unwanted thoughts and repetitive actions. Such repetitive thoughts and/or behaviors may be reinforced either by reducing anxiety or by avoiding a potential threat or harm, and thus may be rewarding to the individual. The possible involvement of the reward system in the symptomatology of OCD is supported by studies showing altered reward processing in reward-related regions, such as the ventral striatum (VS) and the orbitofrontal cortex (OFC), in adults with OCD. However, it is not clear whether this also applies to adolescents with OCD. METHODS: Using functional magnetic resonance imaging, two sessions were conducted focusing on the anticipation and receipt of monetary reward (1) or loss (2), each contrasted to a verbal (control) condition. In each session, adolescents with OCD (n1=31/n2=26) were compared with typically developing (TD) controls (n1=33/ n2=31), all aged 10-19 years, during the anticipation and feedback phase of an adapted Monetary Incentive Delay task. RESULTS: Data revealed a hyperactivation of the VS, but not the OFC, when anticipating both monetary reward and loss in the OCD compared to the TD group. CONCLUSIONS: These findings suggest that aberrant neural reward and loss processing in OCD is associated with greater motivation to gain or maintain a reward but not with the actual receipt. The greater degree of reward 'wanting' may contribute to adolescents with OCD repeating certain actions more and more frequently, which then become habits (i.e., OCD symptomatology).


Asunto(s)
Anticipación Psicológica , Imagen por Resonancia Magnética , Trastorno Obsesivo Compulsivo , Recompensa , Estriado Ventral , Humanos , Adolescente , Trastorno Obsesivo Compulsivo/fisiopatología , Trastorno Obsesivo Compulsivo/psicología , Trastorno Obsesivo Compulsivo/diagnóstico por imagen , Masculino , Femenino , Anticipación Psicológica/fisiología , Estriado Ventral/fisiopatología , Estriado Ventral/diagnóstico por imagen , Adulto Joven , Niño , Corteza Prefrontal/fisiopatología , Corteza Prefrontal/diagnóstico por imagen , Motivación/fisiología
2.
J Affect Disord ; 356: 257-266, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38588725

RESUMEN

BACKGROUND: Nature therapies are gaining attention as non-pharmacological treatments for depressive and anxiety disorders, but research on their effectiveness in patients is limited. This study investigates the mood-improving effects of visual stimulation with natural environmental images in patients with depressive and anxiety disorders. METHODS: We conducted a randomized crossover comparison trial involving 60 right-handed adult participants with depressive or anxiety disorders and receiving outpatient treatment. Visual stimuli of natural environments consisted of green-themed nature images, while the control stimuli featured urban scenes dominated by buildings. The stimulation lasted for 3 min, during which orbital prefrontal brain activity was measured using a 2-channel Near-infrared Spectroscopy (NIRS) system, and heart rate variability was assessed using fingertip accelerated plethysmography. RESULTS: Mood enhancement effects were observed in both the depressive and anxiety disorder groups following visual stimulation with nature images. In the depression group, orbital prefrontal oxygenated hemoglobin concentration significantly increased after visual stimulation with nature images, while there were no significant changes in the anxiety group. However, in the anxiety group, a correlation was found between reduced orbital prefrontal oxygenated hemoglobin in response to nature images and increased mood-enhancement. Furthermore, the severity of depressive symptoms did not significantly affect the intervention effects, whereas heightened anxiety symptoms was associated with a smaller mood enhancement effect. DISCUSSION: Our study demonstrates the benefits of nature image stimulation for patients with depressive and anxiety disorders. Differential orbital prefrontal brain activity impacts notwithstanding, both conditions exhibited mood enhancement, affirming the value of nature image stimulation.


Asunto(s)
Afecto , Trastornos de Ansiedad , Estudios Cruzados , Frecuencia Cardíaca , Estimulación Luminosa , Corteza Prefrontal , Espectroscopía Infrarroja Corta , Humanos , Femenino , Masculino , Adulto , Afecto/fisiología , Trastornos de Ansiedad/terapia , Trastornos de Ansiedad/fisiopatología , Corteza Prefrontal/fisiopatología , Frecuencia Cardíaca/fisiología , Trastorno Depresivo/terapia , Trastorno Depresivo/fisiopatología , Persona de Mediana Edad , Naturaleza , Ambiente , Adulto Joven
3.
J Affect Disord ; 356: 88-96, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38588729

RESUMEN

OBJECTIVE: Subthreshold depression is an essential precursor and risk factor for major depressive disorder, and its accurate identification and timely intervention are important for reducing the prevalence of major depressive disorder. Therefore, we used functional near-infrared spectroscopic imaging (fNIRS) to explore the characteristics of the brain neural activity of college students with subthreshold depression in the verbal fluency task. METHODS: A total of 72 subthreshold depressed college students (SDs) and 67 healthy college students (HCs) were recruited, and all subjects were subjected to a verbal fluency task (VFT) while a 53-channel fNIRS device was used to collect the subjects' cerebral blood oxygenation signals. RESULTS: The results of the independent samples t-test showed that the mean oxyhemoglobin in the right dorsolateral prefrontal (ch34, ch42, ch45) and Broca's area (ch51, ch53) of SDs was lower than that of HCs. The peak oxygenated hemoglobin of SDs was lower in the right dorsolateral prefrontal (ch34) and Broca's area (ch51, ch53).The brain functional connectivity strength was lower than that of HCs. Correlation analysis showed that the left DLPFC and Broca's area were significantly negatively correlated with the depression level. CONCLUSION: SDs showed abnormally low, inadequate levels of brain activation and weak frontotemporal brain functional connectivity. The right DLPFC has a higher sensitivity for the differentiation of depressive symptoms and is suitable as a biomarker for the presence of depressive symptoms. Dysfunction in Broca's area can be used both as a marker of depressive symptoms and as a biomarker, indicating the severity of depressive symptoms.


Asunto(s)
Depresión , Oxihemoglobinas , Espectroscopía Infrarroja Corta , Humanos , Oxihemoglobinas/metabolismo , Masculino , Femenino , Adulto Joven , Adulto , Depresión/fisiopatología , Depresión/metabolismo , Área de Broca/fisiopatología , Corteza Prefontal Dorsolateral/fisiopatología , Corteza Prefontal Dorsolateral/metabolismo , Corteza Prefrontal/fisiopatología , Corteza Prefrontal/metabolismo , Corteza Prefrontal/diagnóstico por imagen
4.
J Affect Disord ; 356: 499-506, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38574869

RESUMEN

BACKGROUND: Suicide is one of the most lethal complications of late-life depression (LLD), and habenular dysfunction may be involved in depression-related suicidality and may serve as a potential target for alleviating suicidal ideation. This study aimed to investigate abnormal functional connectivity of the habenula in LLD patients with suicidal ideation. METHODS: One hundred twenty-seven patients with LLD (51 with suicidal ideation (LLD-S) and 76 without suicidal ideation (LLD-NS)) and 75 healthy controls (HCs) were recruited. The static functional connectivity (sFC) and dynamic functional connectivity (dFC) between the habenula and the whole brain were compared among the three groups, and correlation and moderation analyses were applied to investigate whether suicidal ideation moderated the relationships of habenular FC with depressive symptoms and cognitive impairment. RESULTS: The dFC between the right habenula and the left orbitofrontal cortex (OFC) increased in the following order: LLD-S > LLD-NS > control. No significant difference in the habenular sFC was found among the LLD-S, LLD-NS and control groups. The dFC between the right habenula and the left OFC was positively associated with global cognitive function and visuospatial skills, and the association between this dFC and visuospatial skills was moderated by suicidal ideation in patients with LLD. CONCLUSION: The increased variability in dFC between the right habenula and left OFC was more pronounced in the LLD-S group than in the LLD-NS group, and the association between habenular-OFC dFC and visuospatial skills was moderated by suicidal ideation in patients with LLD.


Asunto(s)
Habénula , Imagen por Resonancia Magnética , Ideación Suicida , Humanos , Habénula/fisiopatología , Femenino , Masculino , Anciano , Persona de Mediana Edad , Corteza Prefrontal/fisiopatología , Corteza Prefrontal/diagnóstico por imagen , Depresión/fisiopatología , Depresión/psicología , Estudios de Casos y Controles , Trastorno Depresivo/fisiopatología , Trastorno Depresivo/psicología
5.
PLoS One ; 19(4): e0300243, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38662740

RESUMEN

Gait impairments negatively affect the quality of life of people with Parkinson's disease (PwPD). Aerobic exercise (AE) is an alternative to alleviate these impairments and its combination with transcranial direct current stimulation (tDCS) has demonstrated synergistic effects. However, the effect of multitarget tDCS application (i.e., motor, and prefrontal cortices simultaneously) combined with physical exercise on gait impairments is still little known. Thus, the proposed randomized clinical trial will verify the acute effects of AE combined with tDCS applied on motor and prefrontal cortices separately and simultaneously on gait (spatial-temporal and cortical activity parameters) in PwPD. Twenty-four PwPD in Hoehn & Yahr stages I-III will be recruited for this crossover study. PwPD will practice AE on treadmill simultaneously with the application of anodal tDCS during four intervention sessions on different days (∼ one week of interval). Active tDCS will be applied to the primary motor cortex, prefrontal cortex, and both areas simultaneously (multitarget), with an intensity of 2 mA for 20 min. For sham, the stimulation will remain at 2 mA for 10 s. The AE will last a total of 30 min, consisting of warm-up, main part (20 min with application of tDCS), and recovery. Exercise intensity will be controlled by heart rate. Spatial-temporal and cortical activity parameters will be acquired before and after each session during overground walking, walking with obstacle avoidance, and walking with a cognitive dual task at self-preferred velocity. An accelerometer will be positioned on the fifth lumbar vertebra to obtain the spatial-temporal parameters (i.e., step length, duration, velocity, and swing phase duration). Prefrontal cortex activity will be recorded from a portable functional near-infrared spectroscopy system and oxygenated and deoxygenated hemoglobin concentrations will be analyzed. Two-way ANOVAs with repeated measures for stimulation and moment will be performed. The findings of the study may contribute to improving gait in PwPD. Trial registration: Brazilian Clinical Trials Registry (RBR-738zkp7).


Asunto(s)
Ejercicio Físico , Marcha , Enfermedad de Parkinson , Estimulación Transcraneal de Corriente Directa , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Cruzados , Ejercicio Físico/fisiología , Prueba de Esfuerzo , Terapia por Ejercicio/métodos , Marcha/fisiología , Corteza Motora/fisiopatología , Enfermedad de Parkinson/terapia , Enfermedad de Parkinson/fisiopatología , Corteza Prefrontal/fisiopatología , Corteza Prefrontal/fisiología , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Estimulación Transcraneal de Corriente Directa/métodos
6.
Neuroimage ; 292: 120620, 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38641257

RESUMEN

Social pain, a multifaceted emotional response triggered by interpersonal rejection or criticism, profoundly impacts mental well-being and social interactions. While prior research has implicated the right ventrolateral prefrontal cortex (rVLPFC) in mitigating social pain, the precise neural mechanisms and downstream effects on subsequent social attitudes remain elusive. This study employed transcranial magnetic stimulation (TMS) integrated with fMRI recordings during a social pain task to elucidate these aspects. Eighty participants underwent either active TMS targeting the rVLPFC (n = 41) or control stimulation at the vertex (n = 39). Our results revealed that TMS-induced rVLPFC facilitation significantly reduced self-reported social pain, confirming the causal role of the rVLPFC in social pain relief. Functional connectivity analyses demonstrated enhanced interactions between the rVLPFC and the dorsolateral prefrontal cortex, emphasizing the collaborative engagement of prefrontal regions in emotion regulation. Significantly, we observed that negative social feedback led to negative social attitudes, whereas rVLPFC activation countered this detrimental effect, showcasing the potential of the rVLPFC as a protective buffer against adverse social interactions. Moreover, our study uncovered the impact role of the hippocampus in subsequent social attitudes, a relationship particularly pronounced during excitatory TMS over the rVLPFC. These findings offer promising avenues for improving mental health within the intricate dynamics of social interactions. By advancing our comprehension of the neural mechanisms underlying social pain relief, this research introduces novel intervention strategies for individuals grappling with social distress. Empowering individuals to modulate rVLPFC activation may facilitate reshaping social attitudes and successful reintegration into communal life.


Asunto(s)
Imagen por Resonancia Magnética , Corteza Prefrontal , Estimulación Magnética Transcraneal , Humanos , Estimulación Magnética Transcraneal/métodos , Masculino , Femenino , Adulto Joven , Corteza Prefrontal/fisiología , Corteza Prefrontal/diagnóstico por imagen , Corteza Prefrontal/fisiopatología , Adulto , Actitud , Interacción Social , Dolor/fisiopatología , Dolor/psicología , Mapeo Encefálico/métodos , Corteza Prefontal Dorsolateral/fisiología , Corteza Prefontal Dorsolateral/diagnóstico por imagen
7.
Ann Clin Transl Neurol ; 11(5): 1365-1370, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38509632

RESUMEN

OBJECTIVE: According to a seminal hypothesis stated by Crick and Koch in 1995, one is not aware of neural activity in primary visual cortex (V1) because this region lacks reciprocal connections with prefrontal cortex (PFC). METHODS: We provide here a neuropsychological illustration of this hypothesis in a patient with a very rare form of cortical blindness: ventral and dorsal cortical pathways were lesioned bilaterally while V1 areas were partially preserved. RESULTS: Visual stimuli escaped conscious perception but still activated V1 regions that were functionally disconnected from PFC. INTERPRETATION: These results are consistent with the hypothesis of a causal role of PFC in visual awareness.


Asunto(s)
Corteza Visual Primaria , Humanos , Corteza Visual Primaria/fisiología , Corteza Visual Primaria/fisiopatología , Ceguera Cortical/fisiopatología , Masculino , Concienciación/fisiología , Percepción Visual/fisiología , Corteza Prefrontal/fisiopatología , Corteza Prefrontal/fisiología , Pruebas Neuropsicológicas , Femenino , Adulto , Imagen por Resonancia Magnética
8.
Neurorehabil Neural Repair ; 38(5): 364-372, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38506532

RESUMEN

BACKGROUND: Concussions result in transient symptoms stemming from a cortical metabolic energy crisis. Though this metabolic energy crisis typically resolves in a month, symptoms can persist for years. The symptomatic period is associated with gait dysfunction, the cortical underpinnings of which are poorly understood. Quantifying prefrontal cortex (PFC) activity during gait may provide insight into post-concussion gait dysfunction. The purpose of this study was to explore the effects of persisting concussion symptoms on PFC activity during gait. We hypothesized that adults with persisting concussion symptoms would have greater PFC activity during gait than controls. Within the concussed group, we hypothesized that worse symptoms would relate to increased PFC activity during gait, and that increased PFC activity would relate to worse gait characteristics. METHODS: The Neurobehavior Symptom Inventory (NSI) characterized concussion symptoms. Functional near-infrared spectroscopy quantified PFC activity (relative concentration changes of oxygenated hemoglobin [HbO2]) in 14 people with a concussion and 25 controls. Gait was assessed using six inertial sensors in the concussion group. RESULTS: Average NSI total score was 26.4 (13.2). HbO2 was significantly higher (P = .007) for the concussed group (0.058 [0.108]) compared to the control group (-0.016 [0.057]). Within the concussion group, HbO2 correlated with NSI total symptom score (ρ = .62; P = .02), sagittal range of motion (r = .79; P = .001), and stride time variability (r = -.54; P = .046). CONCLUSION: These data suggest PFC activity relates to symptom severity and some gait characteristics in people with persistent concussion symptoms. Identifying the neurophysiological underpinnings to gait deficits post-concussion expands our knowledge of motor behavior deficits in people with persistent concussion symptoms.


Asunto(s)
Conmoción Encefálica , Síndrome Posconmocional , Corteza Prefrontal , Espectroscopía Infrarroja Corta , Humanos , Corteza Prefrontal/fisiopatología , Corteza Prefrontal/diagnóstico por imagen , Masculino , Femenino , Adulto , Conmoción Encefálica/fisiopatología , Conmoción Encefálica/complicaciones , Adulto Joven , Síndrome Posconmocional/fisiopatología , Síndrome Posconmocional/etiología , Trastornos Neurológicos de la Marcha/etiología , Trastornos Neurológicos de la Marcha/fisiopatología , Persona de Mediana Edad , Marcha/fisiología
10.
Brain Stimul ; 17(2): 324-332, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38453003

RESUMEN

The smoking rate is high in patients with schizophrenia. Brain stimulation targeting conventional brain circuits associated with nicotine addiction has also yielded mixed results. We aimed to identify alternative circuitries associated with nicotine addiction in both the general population and schizophrenia, and then test whether modulation of such circuitries may alter nicotine addiction behaviors in schizophrenia. In Study I of 40 schizophrenia smokers and 51 non-psychiatric smokers, cross-sectional neuroimaging analysis identified resting state functional connectivity (rsFC) between the dorsomedial prefrontal cortex (dmPFC) and multiple extended amygdala regions to be most robustly associated with nicotine addiction severity in healthy controls and schizophrenia patients (p = 0.006 to 0.07). In Study II with another 30 patient smokers, a proof-of-concept, patient- and rater-blind, randomized, sham-controlled rTMS design was used to test whether targeting the newly identified dmPFC location may causally enhance the rsFC and reduce nicotine addiction in schizophrenia. Although significant interactions were not observed, exploratory analyses showed that this dmPFC-extended amygdala rsFC was enhanced by 4-week active 10Hz rTMS (p = 0.05) compared to baseline; the severity of nicotine addiction showed trends of reduction after 3 and 4 weeks (p ≤ 0.05) of active rTMS compared to sham; Increased rsFC by active rTMS predicted reduction of cigarettes/day (R = -0.56, p = 0.025 uncorrected) and morning smoking severity (R = -0.59, p = 0.016 uncorrected). These results suggest that the dmPFC-extended amygdala circuit may be linked to nicotine addiction in schizophrenia and healthy individuals, and future efforts targeting its underlying pathophysiological mechanisms may yield more effective treatment for nicotine addiction.


Asunto(s)
Imagen por Resonancia Magnética , Esquizofrenia , Tabaquismo , Estimulación Magnética Transcraneal , Humanos , Esquizofrenia/diagnóstico por imagen , Esquizofrenia/fisiopatología , Esquizofrenia/terapia , Tabaquismo/terapia , Tabaquismo/diagnóstico por imagen , Tabaquismo/fisiopatología , Masculino , Adulto , Femenino , Estimulación Magnética Transcraneal/métodos , Corteza Prefrontal/diagnóstico por imagen , Corteza Prefrontal/fisiopatología , Persona de Mediana Edad , Amígdala del Cerebelo/diagnóstico por imagen , Amígdala del Cerebelo/fisiopatología , Neuroimagen , Estudios Transversales
11.
Exp Brain Res ; 242(5): 1087-1100, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38483566

RESUMEN

Fatigue and balance disorders are common challenges experienced by Multiple Sclerosis (MS) individuals. The purpose of this study was to compare the concurrent effects of cerebellar and prefrontal anodal trans-cranial direct current stimulation (a-tDCS) with postural training on balance and fatigue in MS patients. 51 patients were evaluated to randomly allocation to a-tDCS over cerebellum, a-tDCS over dorsolateral prefrontal cortex (DLPFC) and sham group. 46 individuals (n = 16 in experimental groups and n = 14 in control group) followed treatment. All the groups received 10 sessions of postural training. The experimental groups underwent a-tDCS with a current of 1.5 mA for a period of 20 min. While, in the sham group, tDCS was only activated for 30 s and then turned off. The treatment included 10 sessions for four weeks. Before and after intervention, fatigue and balance were assessed using Fatigue Severity Scale (FSS), Timed Up and Go (TUG) test and Berg Balance Score (BBS), respectively. There was found a significant reduction in fatigue in the group receiving a-tDCS over the prefrontal cortex with postural training compared to the other two groups (P < 0.001). Additionally, a significant improvement was found in balance in the group receiving a-tDCS over the cerebellum concurrent with postural training in comparison to the other two groups (P < 0.001). Besides, in the sham group, the significant results were not reported in the variables. (P > 0.001). The results demonstrated that a-tDCS enhances the effects of postural training on balance and fatigue in MS patients.


Asunto(s)
Cerebelo , Fatiga , Esclerosis Múltiple , Equilibrio Postural , Corteza Prefrontal , Estimulación Transcraneal de Corriente Directa , Humanos , Masculino , Femenino , Equilibrio Postural/fisiología , Estimulación Transcraneal de Corriente Directa/métodos , Adulto , Método Doble Ciego , Esclerosis Múltiple/complicaciones , Esclerosis Múltiple/fisiopatología , Esclerosis Múltiple/terapia , Fatiga/terapia , Fatiga/fisiopatología , Fatiga/etiología , Fatiga/rehabilitación , Persona de Mediana Edad , Corteza Prefrontal/fisiopatología , Cerebelo/fisiopatología , Cerebelo/fisiología , Resultado del Tratamiento , Adulto Joven
12.
Exp Brain Res ; 242(5): 1149-1160, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38489023

RESUMEN

Hypofunctioning of NMDA receptors, and the resulting shift in the balance between excitation and inhibition, is considered a key process in the pathophysiology of schizophrenia. One important manifestation of this phenomenon is changes in neural oscillations, those above 30 Hz (i.e., gamma-band oscillations), in particular. Although both preclinical and clinical studies observed increased gamma activity following acute administration of NMDA receptor antagonists, the relevance of this phenomenon has been recently questioned given the reduced gamma oscillations typically observed during sensory and cognitive tasks in schizophrenia. However, there is emerging, yet contradictory, evidence for increased spontaneous gamma-band activity (i.e., at rest or under baseline conditions). Here, we use the sub-chronic phencyclidine (PCP) rat model for schizophrenia, which has been argued to model the pathophysiology of schizophrenia more closely than acute NMDA antagonism, to investigate gamma oscillations (30-100 Hz) in the medial prefrontal cortex of anesthetized animals. While baseline gamma oscillations were not affected, oscillations induced by train stimulation of the posterior dorsal CA1 (pdCA1) field of the hippocampus were enhanced in PCP-treated animals (5 mg/kg, twice daily for 7 days, followed by a 7-day washout period). This effect was reversed by pharmacological enhancement of endocannabinoid levels via systemic administration of URB597 (0.3 mg/kg), an inhibitor of the catabolic enzyme of the endocannabinoid anandamide. Intriguingly, the pharmacological blockade of CB1 receptors by AM251 unmasked a reduced gamma oscillatory activity in PCP-treated animals. The findings are consistent with the observed effects of URB597 and AM251 on behavioral deficits reminiscent of the symptoms of schizophrenia and further validate the potential for cannabinoid-based drugs as a treatment for schizophrenia.


Asunto(s)
Amidohidrolasas , Benzamidas , Carbamatos , Modelos Animales de Enfermedad , Ritmo Gamma , Fenciclidina , Piperidinas , Corteza Prefrontal , Esquizofrenia , Animales , Esquizofrenia/fisiopatología , Esquizofrenia/metabolismo , Esquizofrenia/tratamiento farmacológico , Fenciclidina/farmacología , Corteza Prefrontal/efectos de los fármacos , Corteza Prefrontal/metabolismo , Corteza Prefrontal/fisiopatología , Ritmo Gamma/fisiología , Ritmo Gamma/efectos de los fármacos , Masculino , Ratas , Carbamatos/farmacología , Benzamidas/farmacología , Amidohidrolasas/antagonistas & inhibidores , Amidohidrolasas/metabolismo , Piperidinas/farmacología , Pirazoles/farmacología , Antagonistas de Aminoácidos Excitadores/farmacología , Antagonistas de Aminoácidos Excitadores/administración & dosificación , Endocannabinoides/metabolismo , Ácidos Araquidónicos/metabolismo , Ácidos Araquidónicos/farmacología , Ratas Sprague-Dawley , Alcamidas Poliinsaturadas/metabolismo , Alcamidas Poliinsaturadas/farmacología
13.
JAMA Psychiatry ; 81(5): 437-446, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38446471

RESUMEN

Importance: Posttraumatic stress disorder (PTSD) is a common psychiatric disorder that is particularly difficult to treat in military veterans. Noninvasive brain stimulation has significant potential as a novel treatment to reduce PTSD symptoms. Objective: To test whether active transcranial direct current stimulation (tDCS) plus virtual reality (VR) is superior to sham tDCS plus VR for warzone-related PTSD. Design, Setting, and Participants: This double-blind randomized clinical trial was conducted among US military veterans enrolled from April 2018 to May 2023 at a secondary care Department of Veterans Affairs hospital and included 1- and 3-month follow-up visits. Participants included US military veterans with chronic PTSD and warzone-related exposure, recruited via referral and advertisement. Patients in psychiatric treatment had to be on a stable regimen for at least 6 weeks to be eligible for enrollment. Data were analyzed from May to September 2023. Intervention: Participants were randomly assigned to receive 2-mA anodal tDCS or sham tDCS targeted to the ventromedial prefrontal cortex, during six 25-minute sessions of standardized warzone VR exposure, delivered over 2 to 3 weeks. Main Outcomes and Measures: The co-primary outcomes were self-reported PTSD symptoms, measured via the PTSD checklist for DSM-5 (PCL-5), alongside quality of life. Other outcomes included psychophysiological arousal, clinician-assessed PTSD, depression, and social/occupational function. Results: A total of 54 participants (mean [SD] age, 45.7 [10.5] years; 51 [94%] males) were assessed, including 26 in the active tDCS group and 28 in the sham tDCS group. Participants in the active tDCS group reported a superior reduction in self-reported PTSD symptom severity at 1 month (t = -2.27, P = .02; Cohen d = -0.82). There were no significant differences in quality of life between active and sham tDCS groups. Active tDCS significantly accelerated psychophysiological habituation to VR events between sessions compared with sham tDCS (F5,7689.8 = 4.65; P < .001). Adverse effects were consistent with the known safety profile of the corresponding interventions. Conclusions and Relevance: These findings suggest that combined tDCS plus VR may be a promising strategy for PTSD reduction and underscore the innovative potential of these combined technologies. Trial Registration: ClinicalTrials.gov Identifier: NCT03372460.


Asunto(s)
Corteza Prefrontal , Trastornos por Estrés Postraumático , Estimulación Transcraneal de Corriente Directa , Veteranos , Humanos , Trastornos por Estrés Postraumático/terapia , Estimulación Transcraneal de Corriente Directa/métodos , Masculino , Femenino , Método Doble Ciego , Adulto , Veteranos/psicología , Persona de Mediana Edad , Corteza Prefrontal/fisiopatología , Terapia de Exposición Mediante Realidad Virtual/métodos , Realidad Virtual
15.
J Neurol ; 271(5): 2615-2630, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38345630

RESUMEN

INTRODUCTION: Mal de Debarquement Syndrome (MdDS) is a rare central vestibular disorder characterised by a constant sensation of motion (rocking, swaying, bobbing), which typically arises after motion experiences (e.g. sea, air, and road travel), though can be triggered by non-motion events. The current standard of care is non-specific medications and interventions that only result in mild-to-moderate improvements. The vestibular ocular reflex (VOR) rehabilitation protocol, a specialised form of rehabilitation, has shown promising results in reducing symptoms amongst people with MdDS. Accumulating evidence suggests that it may be possible to augment the effects of VOR rehabilitation via non-invasive brain stimulation protocols, such as theta burst stimulation (TBS). METHODS: The aim of this randomised controlled trial was to evaluate the effectiveness of intermittent TBS (iTBS) over the dorsolateral prefrontal cortex in enhancing the effectiveness of a subsequently delivered VOR rehabilitation protocol in people with MdDS. Participants were allocated randomly to receive either Sham (n = 10) or Active (n = 10) iTBS, followed by the VOR rehabilitation protocol. Subjective outcome measures (symptom ratings and mental health scores) were collected 1 week pre-treatment and for 16 weeks post-treatment. Posturography (objective outcome) was recorded each day of the treatment week. RESULTS: Significant improvements in subjective and objective outcomes were reported across both treatment groups over time, but no between-group differences were observed. DISCUSSION: These findings support the effectiveness of the VOR rehabilitation protocol in reducing MdDS symptoms. Further research into iTBS is required to elucidate whether the treatment has a role in the management of MdDS. TRN: ACTRN12619001519145 (Date registered: 04 November 2019).


Asunto(s)
Reflejo Vestibuloocular , Estimulación Magnética Transcraneal , Humanos , Masculino , Femenino , Estimulación Magnética Transcraneal/métodos , Persona de Mediana Edad , Adulto , Reflejo Vestibuloocular/fisiología , Terapia Combinada , Enfermedad Relacionada con los Viajes , Corteza Prefrontal/fisiopatología , Anciano , Evaluación de Resultado en la Atención de Salud , Ritmo Teta/fisiología
16.
J Psychiatr Res ; 165: 233-240, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37523975

RESUMEN

BACKGROUND: Impaired decision-making was observed in internet gaming disorder (IGD), however, these studies did not differentiate 'hard' to 'easy' decisions, and only the 'hard' decision-making could reveal the mechanism underlying this issue. METHODS: We recruited forty-eight individuals with IGD and forty-six recreational internet game users (RGUs) as a control group in this study. fMRI data were collected when they were finishing a value-matching delayed discount task (DDT), which included easy and hard decisions judging based on the indifference points of every participant. The correlations between brain responses during DDT and IGD severity and the effective connectivity between brain regions were calculated. RESULTS: Compared to RGUs, IGD subjects showed enhanced activation in the orbitofrontal cortex (OFC) when facing hard choices, and this feature was associated with IGD severity. In addition, individuals with IGD showed increased effective connectivity from the OFC to the dorsolateral prefrontal cortex and the OFC to the occipital lobe and decreased effective connectivity from the occipital lobe to the OFC. CONCLUSION: The current study showed that the abnormal activation in the OFC was associated with IGD severity and higher OFC-DLPFC/OFC-occipital lobe effective connectivity and lower occipital lobe-OFC effective connectivity when individuals with IGD faced different choices in the DDT. These findings suggest the neural mechanisms of impulsive decision-making in individuals with IGD due to dysfunction with subjective evaluation and dysfunction of the connection with the executive control system.


Asunto(s)
Encéfalo , Descuento por Demora , Trastorno de Adicción a Internet , Femenino , Humanos , Masculino , Adulto Joven , Análisis de Varianza , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Encéfalo/fisiopatología , Corteza Prefontal Dorsolateral/patología , Corteza Prefontal Dorsolateral/fisiopatología , Función Ejecutiva , Trastorno de Adicción a Internet/diagnóstico por imagen , Trastorno de Adicción a Internet/patología , Trastorno de Adicción a Internet/fisiopatología , Imagen por Resonancia Magnética , Lóbulo Occipital/patología , Lóbulo Occipital/fisiopatología , Corteza Prefrontal/patología , Corteza Prefrontal/fisiopatología , Tiempo de Reacción , Recompensa
17.
Brain Res ; 1817: 148469, 2023 10 15.
Artículo en Inglés | MEDLINE | ID: mdl-37355150

RESUMEN

OBJECTIVE: To explore the abnormalities of brain function in blepharospasm (BSP) and to illustrate its neural mechanisms by assuming supplementary motor area (SMA) as the entry point. METHODS: Twenty-five patients with BSP and 23 controls underwent resting-state functional MRI, seed-based functional connectivity (FC), correlation analysis, receiver operating characteristic curve (ROC) analysis, and support vector machine (SVM) were applied to process the data. RESULTS: Patients showed that the left medial prefrontal cortex (MPFC), left lingual gyrus, right cerebellar crus I, and right lingual gyrus/cerebellar crus I had enhanced FC with the left SMA, whereas the right inferior temporal gyrus (ITG) had enhanced FC with the right SMA relative to controls. The FC between the left MPFC and left SMA was positively correlated with symptomatic severity. The ROC analysis verified that the abnormal FCs demonstrated in this study can separate patients and controls at high sensitivity and specificity. SVM analysis exhibited that combined FCs of the left SMA were optimal for distinguishing patients and control group at the accuracy of 89.58%, with sensitivity of 92.00% and specificity of 86.96%. CONCLUSIONS: Several brain networks partake in the neurobiology of BSP. SMA plays a vital role in several brain networks and might be the key pathogenic factor in BSP. SIGNIFICANCE: Providing novel evidence for the engagement of the MPFC in the motor symptoms of BSP, enhancing credibility of the thesis that SMA regulates the neurobiology of BSP, and providing ideas of screening susceptible population of BSP using neuroimaging.


Asunto(s)
Blefaroespasmo , Conectoma , Corteza Motora , Máquina de Vectores de Soporte , Humanos , Blefaroespasmo/diagnóstico por imagen , Blefaroespasmo/fisiopatología , Corteza Motora/diagnóstico por imagen , Corteza Motora/fisiopatología , Descanso , Corteza Prefrontal/diagnóstico por imagen , Corteza Prefrontal/fisiopatología , Masculino , Adulto , Persona de Mediana Edad , Imagen por Resonancia Magnética
18.
Glia ; 71(8): 1906-1920, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37017183

RESUMEN

Microglia participates in the modulation of pain signaling. The activation of microglia is suggested to play an important role in affective disorders that are related to a dysfunction of the mesocorticolimbic system (MCLS) and are commonly associated with chronic pain. Moreover, there is evidence that mu-opioid receptors (MORs), expressed in the MCLS, are involved in neuroinflammatory events, although the way by which they do it remains to be elucidated. In this study, we propose that MOR pharmacological activation within the MCLS activates and triggers the local release of proinflammatory cytokines and this pattern of activation is impacted by the presence of systemic inflammatory pain. To test this hypothesis, we used in vivo microdialysis coupled with flow cytometry to measure cytokines release in the nucleus accumbens and immunofluorescence of IBA1 in areas of the MCLS on a rat model of inflammatory pain. Interestingly, the treatment with DAMGO, a MOR agonist locally in the nucleus accumbens, triggered the release of the IL1α, IL1ß, and IL6 proinflammatory cytokines. Furthermore, MOR pharmacological activation in the ventral tegmental area (VTA) modified the levels of IBA1-positive cells in the VTA, prefrontal cortex, the nucleus accumbens and the amygdala in a dose-dependent way, without impacting mechanical nociception. Additionally, MOR blockade in the VTA prevents DAMGO-induced effects. Finally, we observed that systemic inflammatory pain altered the IBA1 immunostaining derived from MOR activation in the MSCLS. Altogether, our results indicate that the microglia-MOR relationship could be pivotal to unravel some inflammatory pain-induced comorbidities related to MCLS dysfunction.


Asunto(s)
Dolor Crónico , Microglía , Enfermedades Neuroinflamatorias , Corteza Prefrontal , Receptores Opioides mu , Área Tegmental Ventral , Receptores Opioides mu/agonistas , Receptores Opioides mu/metabolismo , Enfermedades Neuroinflamatorias/metabolismo , Enfermedades Neuroinflamatorias/fisiopatología , Microglía/metabolismo , Área Tegmental Ventral/metabolismo , Área Tegmental Ventral/fisiopatología , Corteza Prefrontal/metabolismo , Corteza Prefrontal/fisiopatología , Animales , Ratas , Modelos Animales de Enfermedad , Dolor Crónico/metabolismo , Dolor Crónico/fisiopatología , Núcleo Accumbens/metabolismo , Núcleo Accumbens/fisiopatología , Proteínas de Unión al Calcio/metabolismo , Proteínas de Microfilamentos/metabolismo , Encefalina Ala(2)-MeFe(4)-Gli(5)/farmacología , Masculino , Femenino , Ratas Sprague-Dawley
19.
Physiol Behav ; 263: 114107, 2023 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-36740134

RESUMEN

Early life stress (ELS) can set the stage for susceptibility to cognitive and emotional dysfunction in adulthood by disrupting typical neural development. The prefrontal cortex (PFC) continues to mature during early life, making this region particularly vulnerable to disruption for animals who experience ELS. Despite this, the effects of ELS experience on in vivo PFC function in awake and behaving adult animals are currently poorly understood. To assess this, we employed an instrumental conflict task to assess how hungry adult rats, either ELS (wet bedding) or unstressed Controls, were able to flexibly alter their motivation for food reward seeking (lever presses) in situations that were either threatening or safe. During this task, in vivo electrophysiological recordings (both single unit and local field potentials [LFPs]) were made in the rats' ventral-medial PFC (vmPFC). We found that ELS rats were less motivated to lever press for rewards than Controls in the threat situations during repeated extinction sessions. In recordings taken during this suppression task, Control vmPFC neurons displayed reliable differences between motivated actions, such as between rewarded and unrewarded presses, but ELS neurons failed to differentiate these action-outcome differences. We also found differences in task-related LFP activity between groups; in particular, prior ELS experience appears to induce abnormal changes in low-frequency oscillations during shock-associated threat stimuli prior to presses, as well as diminished higher-frequency oscillations following rewarded presses. Collectively, we demonstrate that ELS experience produces persistent impairment in motivational regulation that is associated with significant changes in in vivo PFC signals. Specifically, ELS-experienced adults fail to appropriately update motivated action strategies under threat conditions, and likewise fail to appropriately monitor and update action/outcome relationships in motivated behavior. These ELS-related changes may therefore lay the foundation for heightened susceptibility to mental-health disorders in adults such as substance abuse and post-traumatic stress disorder.


Asunto(s)
Neuronas , Corteza Prefrontal , Estrés Psicológico , Animales , Ratas , Neuronas/patología , Corteza Prefrontal/citología , Corteza Prefrontal/fisiopatología , Recompensa
20.
Behav Brain Res ; 437: 114113, 2023 02 02.
Artículo en Inglés | MEDLINE | ID: mdl-36108777

RESUMEN

Prepulse inhibition (PPI) allows assessing schizophrenia-like sensorimotor gating deficits in rodents. Previous studies indicate that PPI is modulated by the medial prefrontal cortex (mPFC), which is in agreement with our findings showing that PPI differences in the Roman rats are associated with divergences in mPFC activity. Here, we explore whether differences in PPI and mPFC activity in male Roman rats can be explained by (i) differences in the activation (c-Fos) of inhibitory neurons (parvalbumin (PV) interneurons); and/or (ii) reduced excitatory drive (PSD-95) to PV interneurons. Our data show that low PPI in the Roman high-avoidance (RHA) rats is associated with reduced activation of PV interneurons. Moreover, the RHA rats exhibit decreased density of both PV interneurons and PSD-95 puncta on active PV interneurons. These findings point to reduced cortical inhibition as a candidate to explain the schizophrenia-like features observed in RHA rats and support the role of impaired cortical inhibition in schizophrenia.


Asunto(s)
Interneuronas , Parvalbúminas , Corteza Prefrontal , Esquizofrenia , Filtrado Sensorial , Animales , Masculino , Ratas , Homólogo 4 de la Proteína Discs Large/metabolismo , Interneuronas/fisiología , Parvalbúminas/metabolismo , Corteza Prefrontal/fisiopatología , Ratas Endogámicas , Esquizofrenia/fisiopatología , Filtrado Sensorial/fisiología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA